Okuyama Sonia, Jones Whitney, Ricklefs Christine, Tran Zung Vu
University of Colorado Cancer Center, Cancer Prevention and Control, Aurora, CO, USA.
Colorado School of Public Health, Department of Community and Behavioral Health, Aurora, CO, USA.
Psychooncology. 2015 Aug;24(8):857-70. doi: 10.1002/pon.3704. Epub 2014 Oct 18.
Over one third of patients with cancer experience elevated psychosocial distress. As screening for distress becomes more common, the number of patients referred for psychosocial care will increase. Psychosocial telephone interventions are recommended as a convenient and exportable alternative to in-person interventions addressing psychosocial distress. This study reviews the efficacy of randomized controlled trials (RCTs) of psychosocial telephone interventions for patients with cancer.
We conducted a systematic review of peer-reviewed RCTs evaluating telephone interventions in adult patients with cancer across the survivorship continuum.
Through a database search, 480 articles were identified. After manual review, 13 were included, with 7 additional studies identified by back citation, totaling 20 studies. Participants were largely Caucasian, highly educated, with mean age ranging from 49 to 75 years. Most participants were patients with breast cancer (n = 13 studies). Sample sizes were generally small, with most patients recruited from large medical centers. Only one screened for psychosocial need. Interventions varied greatly in length and intensity. Eight studies reported significant effects post-intervention in the hypothesized direction on at least one psychosocial outcome measure. Of these eight studies, four included more than one follow-up assessment; of these, only one reported significant effects at last follow-up. No clear commonalities were found among studies reporting significant effects.
Methodological concerns and lack of consistency in adherence to CONSORT reporting guidelines were identified. This body of research would benefit from well-designed, theory-based RCTs adequately powered to provide more definitive evidence for intervention efficacy. This will probably require multi-institutional collaborations, guided by intervention and research methodology best practices.
超过三分之一的癌症患者存在心理社会困扰加剧的情况。随着困扰筛查变得更加普遍，转介接受心理社会护理的患者数量将会增加。心理社会电话干预被推荐为一种方便且可推广的替代方案，以替代针对心理社会困扰的面对面干预。本研究回顾了针对癌症患者的心理社会电话干预随机对照试验（RCT）的疗效。
我们对同行评审的RCT进行了系统评价，评估了癌症成年患者在整个生存过程中的电话干预情况。
通过数据库搜索，共识别出480篇文章。经过人工评审，纳入了13篇，通过回溯引用又识别出7项研究，共计20项研究。参与者大多为白种人，受过高等教育，平均年龄在49至75岁之间。大多数参与者是乳腺癌患者（n = 13项研究）。样本量一般较小，大多数患者来自大型医疗中心招募。只有一项研究筛查了心理社会需求。干预措施在长度和强度上差异很大。八项研究报告干预后在假设方向上至少对一项心理社会结局指标有显著影响。在这八项研究中，四项包括不止一次随访评估；其中只有一项在最后一次随访时报告有显著影响。在报告有显著影响的研究中未发现明显的共性。
发现了方法学方面的问题以及在遵循CONSORT报告指南方面缺乏一致性。这一系列研究将受益于精心设计、基于理论的RCT，这些RCT有足够的效力为干预效果提供更确凿的证据。这可能需要多机构合作，并以干预和研究方法的最佳实践为指导。
